Abstract

Pakistan is a lower middle-income country, and healthcare in the country is regulated by the Ministry of National Health Services Regulation and Coordination. The overall poor performance in health care is reflected in the form of enormous burden of communicable and non-communicable diseases, and high maternal, neonatal and infant mortality rates. These issues are coupled with a reduced health sector investment and a lack of health insurance schemes. There is no pharmacovigilance system, and there are also problems with counterfeit medications. Nevertheless, Pakistan has a dynamic pharmaceutical sector ranking 10th largest in the Asia-Pacific region and fulfilling 70% of the country’s medicinal demands. Many finished pharmaceutical products from Pakistan have been deemed acceptable by countries across Asia, Africa and the United States.

Pharmaceutical regulation is governed by the Drug Regulatory Authority of Pakistan (DRAP) which ensures the implementation of the Drugs Act, 1976 (XXXI of 1976). Pakistan’s national essential medicine list (NEML) is based on the WHO standards and promotes generic prescribing; however, this list is generally only followed in the public sector hospitals. The majority of prescribers in the private sector health facilities are influenced by pharmaceutical marketing. There are concerns related to underuse and overuse of certain medicines reflecting an irrational medicines use in the country. There are also policy concerns related to drug pricing due to an absence of a sound medicine pricing formula. A full range of essential drugs is not available in public sector hospitals, either because of inadequate operational budget or due to lack of efficient management. Many consumers in Pakistan can buy medicines without prescription, leading to poor dispensing practices. However, despite numerous issues, the country has shown signs of improvement with regard to healthcare system. The Prime Minister’s National Health Insurance Program initiative, the establishment of drug testing laboratories and the strict punishments for the breach of laws related to medicines’ related offences are few examples that show that the government is serious to improve healthcare.